National Provider Identifier Database

CHILDRENS CLINIC OF CLARKSDALE PA
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.


Contact Information

CHILDRENS CLINIC OF CLARKSDALE PA
2245 N STATE STREET
CLARKSDALE, MS38614
Phone: 662-627-4131
Fax: 662-627-2702
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for CHILDRENS CLINIC OF CLARKSDALE PA

NPI Number 1497834030
Legal business name
LBN
CHILDRENS CLINIC OF CLARKSDALE PA
Authorized official CAROLE MANGREM - (PARTNER)
Entity Organization
Organization subpart No
Enumeration date 11/03/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: 07070
  • MS License #: 07191
  • MS License #: R861078
  • MS Medicaid: 09013997

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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